Persistent physical symptoms after COVID-19 infection and the risk of Somatic Symptom Disorder

Objective: Evidence shows that many patients with COVID-19 present persistent symptoms after the acute infection. Some patients may be at a high risk of developing Somatic Symptom Disorder (SSD), in which persistent symptoms are accompanied by excessive and disproportionate health-related thoughts, feelings and behaviors regarding these symptoms. This study assessed the frequency of persistent physical symptoms and SSD and their associated factors in patients with confirmed COVID-19.Methods: We conducted a longitudinal retrospective study after the first two French lockdowns at the Lille University Hospital (France), including all patients with confirmed COVID-19. Persistent physical symptoms and excessive preoccupations for these symptoms were measured 8 to 10 months after the onset of COVID-19. The combination of the Patient Health Questionnaire-15 and the Somatic Symptom Disorder-B Criteria Scale was used to identify the individuals likely to present with SSD. Two linear regression models were performed to identify sociodemographic and medical risk factors of SSD.Results: Among the 377 patients with a laboratory-confirmed diagnosis, 220 (58.4%) completed the question-naires. Sixty-five percent of the 220 included patients required hospitalization, 53.6% presented at least one persistent physical symptom and 10.4% were considered to present SSD. Female sex, older age, infection during the second wave and having probable PTSD were significantly associated with the severity of SSD and SSD was associated with a significantly higher healthcare use.Conclusions: The identification of SSD should encourage clinicians to move beyond the artificial somatic/psy-chiatric dualism and contribute to a better alliance based on multi-disciplinary care.

Automated summary

This study investigated the frequency of persistent physical symptoms and Somatic Symptom Disorder (SSD) in patients with COVID-19 and their associated factors. The results showed that 10.4% of patients were considered to have SSD, and female sex, older age, infection during the second wave, and probable PTSD were associated with the severity of SSD. These findings are important for improving patient care and promoting a multidisciplinary approach.